Individual
JASON TODD WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-4935
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202010861
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
OTHER
VA
Enumeration date
03/21/2022
Last updated
04/23/2024
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